Laparoscopic incisional hernia repair in a porcine model: what do transfixion sutures add?

Background: The aim of this study was to evaluate the need for transfixion sutures during laparoscopic ventral hernia repair with mesh.

Methods: Incisional hernias were created in 14 Yucatan mini-pigs. Animals were randomized to undergo laparoscopic hernia repair either with spiral tacks alone (Tacks) or with tacks and 4 Prolene transfixion sutures (Sutured) using Composix E/X mesh (Davol Inc.

Production and systemic absorption of toxic byproducts of tissue combustion during laparoscopic cholecystectomy.

Among the potential hazards of laparoscopic surgery using electrocautery is the release of chemical by-products of incomplete tissue combustion into the pneumoperitoneum with subsequent transperitoneal absorption into the bloodstream and/or release into the operating room. The purpose of this study of patients undergoing laparoscopic cholecystectomy (LC) was twofold: (1) to assess the relationship between intraperitoneal concentration of carbon monoxide (CO) and blood levels of carboxyhemoglobin (COHb) and methemoglobin (MetHb), and (2) to assess the surgeon's inhalation of CO resulting from ambient smoke exposure. During LC with monopolar electrocautery, 21 patients were evaluated intraoperatively for intraperitoneal [CO] by sampling gas from a trocar, whereas arterial [COHb) and [MetHb] were determined perioperatively.

Laparoscopic hepatic lobectomy in the porcine model.

Background: To date, there have been only a few anecdotal reports of laparoscopic hepatectomy, most of which are limited to wedge resections. The aim of this study was to assess the feasibility of laparoscopic hepatic lobectomy in a porcine model.

Methods: Eight pigs were anesthetized before placement of an abdominal wall lift device and five laparoscopic ports.

Experimental development of an endoscopic approach to neck exploration and parathyroidectomy.

Background: Recent advances in minimally invasive surgical technology have the potential to lead to new applications outside body cavities. The purpose of the present study was to develop techniques for obtaining endoscopic exposure and access to the pretracheal space in the neck with the goal of performing neck exploration and parathyroidectomy and to evaluate the safety and efficacy of such an approach experimentally.

Methods: The technique for endoscopic neck exploration was developed in eight adult mongrel dogs and was further evaluated in a survival dog model and in human cadavers.

Production and systemic absorption of toxic byproducts of tissue combustion during laparoscopic surgery.

Background: Among the potential hazards of laparoscopic surgery using electrocautery is the intraperitoneal release and subsequent absorption of byproducts of tissue combustion. In a porcine model of laparoscopic surgery with smoke production, our aims were to assess (1) the relationship between levels of intraperitoneal carbon monoxide (CO) and systemic carboxyhemoglobin (COHb) and methemoglobin (MetHb), and (2) intraperitoneal concentrations of other noxious gases, including hydrogen cyanide (HCN), acrylonitrile (Acr), and benzene (Bzn).

Methods: Seven pigs underwent laparoscopic resection of three hepatic wedges using monopolar electrocautery in a CO2 pneumoperitoneum.